The Clinical and Translational Science Collaborative (CTSC) of Cleveland is a collaborative venture among five Cleveland health institutions - Case Western Reserve University, the Cleveland Clinic, University Hospitals, MetroHealth Medical Center, and the Veterans Administration Medical Center, as well as community partners. CTSC achieved prior goals of uniting as a collaborative, developed informatics tools, resource sharing, and institutional commitments to enhance the collaborative. Consolidation and catalytic activities begun in the last grant period will be continued. Moreover, CTSC will continue rigorous evaluation of both its operations and progress toward larger goals. CTSC has set three new goals for the next grant period. 1) Translation 1 research will be enhanced. Infrastructure in support of identification and structural determination of therapeutic targets, as well as high through put screening will be implemented. Support systems to assist in patient based research both recruitment and testing will be streamlined and strengthened. Critically, CTSC will create support systems to guide development of potential human therapeutics and diagnostics from discovery to use in man, 2) CTSC will improve health parameters in Cleveland, one of America's poorest and least healthy cities. Community Research Partnership Core is querying the community via neighborhood focus groups to determine their health priorities. At least one of these priorities, and others selected based on the strengths of our CTSC investigative community, will be targeted for special effort. One practice based research network has already succeeded in reducing HgbAlc in 27,000 diabetics in Cleveland by one percentage point in three years, raising optimism that this project can indeed move the needle. 3) CTSC interactions with the national CTSA community will increase. The initial focus of CTSC was inward, establishing connections and catalyzing change in our home institutions, but in the next grant period the CTSC will increase interactions around the consortium. A primary focus will be the Ohio Consortium ofthe three Ohio CTSAs (CTSC, Columbus, Cincinnati), which currently collaborate surrounding child health and cancer projects, and on the web site NetWellness, which has been expanded from simply providing unbiased medical information to include descriptions of clinical research and access to clinical trials. In the next grant period goals will include extending the CTSC IRB electronic hub for facilitated review to include the other CTSA sites, increasing project collaboration, and connecting patient databases via Explorys, a web based informatics tool utilizing the electronic health record. RELEVANCE (See instructions): The CTSC is highly relevant to human health. Using the Cleveland biomedical community as a prototype, we will develop and test electronic and other strategies for coordinating research functions among different institutions, such as IRB approval and facile data sharing. Using the Cleveland community as a laboratory and our practice based research networks and community partnership resource as tools, we will seek to improve health parameters in Cleveland. We will also develop more facile means for Translation 1.